Abstract: A pin guide for the surgical operation of an avascular necrosis of a femoral head includes a guide body having a central pin guide hole extending along a centerline of the guide body and a plurality of side pin guide holes formed so as to make a specified angle with the central pin guide hole. The side pin guide holes are radially arranged around the central pin guide hole at a front side of the guide body and joined to the central pin guide hole at a rear side of the guide body.

Abstract: The channeled bone plate includes a substantially rigid and elongated member for use in stabilizing and splinting fractured sections of a broken bone. This elongated member includes a bottom surface and a top surface, with at least one transverse channel formed from the bottom surface. The transverse channel has a size and shape to at least partially accommodate selective insertion of a cable to permit flush mounting of the bottom surface of the elongated member to the fractured sections of the broken bone simultaneously with flush wrapping of the cable around an external surface of the fractured sections of the broken bone. The elongated member and the cable cooperate to support the broken bone as an implant splint.

Abstract: A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place. The instrument preferably decreases the upward tension applied to the flexible sutures over the duration of the application of twisting. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.

Abstract: The present disclosure relates to a guide assembly. The guide assembly includes a guide having a body having a first set of marks and a joint including at least one through hole, the joint configured for sliding along the length of the body; and a first surgical device having a second set of marks, wherein the guide is coupled to the first surgical device and a longitudinal axis of the through hole is co-radial with a mark of the second set of marks when the joint is located at a mark of the first set of marks. Other guides are also disclosed.

Abstract: A growing spinal rod system is configured to grow in response to the growth of a patient. The growing spinal rod system includes a housing, a spacer, and a sliding spinal rod. The housing includes a stepped passage therethrough. The spacer is disposed within the stepped passage and defines a through hole. The spacer includes a plurality of ribs biased inwards and into the through hole. The sliding spinal rod is slidably inserted through the through hole of the spacer. The sliding spinal rod moves the plurality of ribs outwards. The plurality of ribs permits the sliding spinal rod to extend from the housing and inhibit the sliding spinal rod from retracting into the housing.

Abstract: A cooperative-control robot includes a base component, a mobile platform arranged proximate the base component, a translation assembly operatively connected to the base component and the mobile platform and configured to move the mobile platform with translational degrees of freedom substantially without rotation with respect to said the component, a tool assembly connected to the mobile platform, and a control system configured to communicate with the translation assembly to control motion of the mobile platform in response to forces by a user applied to at least a portion of the cooperative-control robot. The translation assembly includes at least three independently operable actuator arms, each connected to a separate position of the mobile platform. A robotic system includes two or more the cooperative-control robots.

Abstract: The present invention is related to a minimally invasive device for surgical procedures which generally comprises at least a pair of assembly elements formed by a primary main body and a secondary main body joined together at their proximal and distal ends; a fastening element which is inserted in the distal end of both primary and secondary main bodies respectively, which is employed to keep them joined together; a threading element which is inserted in its inner section from the intermediate section of said device, continues to its proximal end and returns to its intermediate section on the opposite end; and a multifunction element located on the inside of the threading element.

Abstract: A puncture assisting tool for assisting in a puncturing operation by a puncture tool that is used to insert and place a spacer between bones and includes an arc-shaped needle includes a base section configured to be in contact with a skin of a patient; and a guide unit configured to be fixed with respect to the base section. The guide unit has a curvature that is approximately the same as a curvature of an arc shape of the puncture tool. The guide unit is configured such that an outer arc-shaped surface of the puncture tool can be placed in contact with the guide unit to guide the puncture tool in an arc trajectory while the puncture tool is being inserted into the patient.

Abstract: A device for binding a cable about a fractured bone to stabilize a fracture includes a slot including a distal opening sized to receive an enlarged end of a cable and a proximal opening sized to permit the cable to slide therethrough while preventing the enlarged end from passing therethough and a bore sized to slidably receive the cable, the bore extending to a proximal opening in combination with a locking element channel extending to a distal end opening into the bore and a locking element movable into a locking position in which a distal end of the locking element extends into the bore to engage a portion of the cable received therein and lock the cable in a desired position within the bore.

Abstract: Described here are closure devices and methods for ligating tissue, such as the left atrial appendage, and tensioning devices and mechanism for actuating these devices. The tensioning mechanisms and devices may allow a user to apply one or more predetermined forces to a suture or other portion of the closure devices. The closure devices may comprise a suture loop releasably attached to a snare loop assembly, and a tensioning mechanism or device may be configured to tighten the suture loop and/or release the suture loop from the snare loop assembly.

Abstract: Drill guides and methods for maintaining contact on bone in areas where rigid instruments cannot access. The drill guide is an articulating drill guide that comprises an articulating mechanism for articulating and positioning the guide in at least two positions, i.e., an undeployed (non-articulated or straight) position and a deployed (articulated or bent) position. The articulating drill guide delivers guide wires, drills and/or additional instruments at any angle while maintaining contact to the bone.

Abstract: A biometric sensor includes a prosthesis for at least one joint having one or more biometric transceivers. The one or more biometric transceivers are capable of transmitting at least one energy wave into a procedure area, quantitatively assessing a behavior of the at least one energy wave, and assessing particulate matter using the at least one energy wave.

Abstract: Various forms of a cable fixation device, instrumentation, kit, and methods useful for repairing the skeletal system are introduced. The system utilizes a clamp housing fixing a butt end of a surgical cable therein. In an operative configuration the cable is looped around a damaged bone segment and reentered through a lock aperture in the clamp housing then through a collet and lock cap residing within the lock aperture. The cable loop and each aforementioned component comprise a central axis aligned within a single plane. A sliding interface situated between the lock cap and collet prevent twisting of the surgical cable. The locking mechanism is non-destructive to the cable despite repeated unlocking and relocking of the fixation device. The axis for tensioning of the cable is coincident with the locking axis. A counter torque instrument has a torsional input shaft generally perpendicular to the elongated axis of the instrument.

Abstract: System, including methods, apparatus, and kits for binding bone. The system may include an encircling member and a fastening member that secures the encircling member in a loop around a portion of bone. In some embodiments, the fastening member may include any combination of the following: a cutting window, a guide aperture to guide a jaw of a crimping tool to a crimp region of the fastening member, multiple crimp regions, and/or apertures to receive adjustable prong members, among others.

Abstract: A spinal fixation device is provided, comprising a body member having a first side and an opposite second side, and an elongate flexible strap having a first section and a second section. The first section of the strap is attached or attachable to attachment means of the body member arranged at a first location thereof. The second section of the strap is sized and shaped to pass through a passageway arranged at a second location of the body member. The strap has a series of teeth and the passageway of the body member has a latch configured for engaging one of the teeth. The teeth and the latch are configured to allow a movement of the second section of the strap through the passageway in a tightening direction from the first side to the second side of the body member, and to prevent a movement of the second section in the opposite direction.

Abstract: This is a system and an assembly for tensioning a flexible strip (3) to hold a bony element on an implant, comprising a shank (15) and means (42) for adjustably immobilizing a component (29) that is capable of translational movement with respect to a portion (25) of the device. The shank (15) comprises a handle (23) for gripping at its second end (24), the portion (25) of the device (14) making an angle with the shank (15), the flexible strip (3) having two free ends. The component (29) capable of movement comprises a wheel (31) free to rotate with respect to a pivot pin (32) perpendicular to the portion (25), for guiding the strip (3) around its rounded periphery (33) comprising two distinct elements (34, 35) for anchoring the flexible strip (3).

Abstract: The present invention provides for a bone fixation device, an implantation instrument, and system which are useful in bone fixation surgeries. The bone fixation device of the instant invention allows the surgeon the ability to navigate the rod while being inserted into a pedicle screw assembly through a non-linear pathway by incrementally changing the direction of travel as desired.

Abstract: A fusion implant for a facet joint comprises a bearing module and a fusion module, in which the fusion model is arranged on the bearing module and has a holder for a transfacetal fastener, whereby the bearing module includes an expansion element and jaw elements, which have contact surfaces for the lamina on their outer sides moving away from each other and which are arranged to move longitudinally on a guide, so that the distance of the fusion module is changeable using the expansion element. The bearing module forms a secure and safe anchoring for the fusion module, which can be repositioned. In addition, the bearing module has the effect of an augmentation, and as a result treatment is possible even on vertabrae that are weakened by defects.

Abstract: An improved olecranon fracture repair device and system. The device includes standoffs to minimize compression of a patient's triceps muscle and tendon. A buttress plate curved to approximate the olecranon process radius accepts a plurality of fixation screws is sized such that the distal end of the plate extends forward of the triceps tendon fibro-osseous junction. The system includes an installation tool having a positioning plate with a moveable member. The positioning plate serves as a stabilizing device, a medullary cavity penetration drill template, and a fixture for guiding the intramedullary rods into the cavities. The moveable member allows for removal of the tool following partial insertion of the repair device intramedullary rods.

Abstract: Devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; one or more (e.g., two) flexible elongate length of cable that extend proximally to distally, a tissue modification region along a portion of the length of cable; and a guidewire coupler at the distal end of the device for attaching the distal end of the tissue modification device to the proximal end of a guidewire. Method of using these devices (including devices having two or more parallel length of cutting regions) to cut tissue (e.g., spinal lamina) are also described.

Abstract: A flexible cable for sternal reconstruction, the cable including first and second ends, the first end of the cable including a crimp fitting member, and the crimp fitting member including a flattened disk-like head. Also provided are methods for sternal reconstruction including wrapping a flexible cable having first and second ends around the sternum, tensioning the flexible cable to a desired tension and securing the tensioned cable, wherein the first end of the cable includes a crimp fitting member, and the crimp fitting member includes a flattened disk-like head.

Abstract: The device includes tubular elements capable of being temporarily fastened at the level of pedicle screw heads arranged to be connected by an implantable curved rod, and at least one rod intended to be movably inserted into slots of each tubular element, to align them for the correction of the spinal column by translation, tilting, and rotation of the vertebrae in the three planes of space. Each tubular element is configured in such a way that it can be coupled with the outside of the pedicle screw heads. The rod forms an alignment and handling rod, being capable of acting, as it moves, on rings for simultaneously displacing the curved rod. Each ring is assembled with the ability to slide along the tubular element, and to be height-adjustable to compensate for dimensional deviations between the alignment and handling rod and the curved rod.

Abstract: Surgical device for correcting deformation of the spinal column includes tubular elements for temporary attachment at pedicle screw heads connected by a curved implantable rod, and rods engaged through the elements to align them corresponding to the correction. Each tubular element has two independent portions coupled to outside of the heads; one end of each part having fittings coupling the portions together. The rods comprise an alignment rod and a handling rod, arranged in openings delimited by the portions to move parallel to an axis of the elements. The handling rod acting, as displaced, to simultaneously displace the curved rod, previously engaged into the openings, towards the heads. The handling rod being removed and then coupled to the outside of the elements arranged in alignment to remove the alignment rod and engage, inside each element, a member actuating a nut for fastening the curved rod in each head.

Abstract: Method of stabilizing a sternum with a fastening member defining a plurality of cleats. In the method, the fastening member may be disposed on a sternum having a discontinuity, with the fastening member spanning the discontinuity and the cleats contacting the sternum. The fastening member may be arranged with a wire or cable such that the wire or cable extends twice through the fastening member and forms a loop around a portion of the sternum. The fastening member may be crimped to secure both ends of the loop to the fastening member.

Abstract: Methods and devices are disclosed for manipulating the hyoid bone, such as to treat obstructive sleep apnea. A conformable implant is positioned adjacent a hyoid bone. The spatial orientation of the hyoid bone is manipulated, to affect the configuration of the airway. The implant restrains the hyoid bone in the manipulated configuration. The implant is positioned adjacent to pharyngeal structures to dilate the pharyngeal airway and/or to support the pharyngeal wall against collapse. The implant may be attached to the hyoid bone using a clamp delivery tool that is adapted to releasably engage the implant.

Abstract: A cable tensioning system includes a reaction frame which contains a sliding platform arranged to move linearly within the frame, and a clam-type cleat attached to the sliding platform. The cleat features one or more grooves, each of which comprises two arrays of opposing ridges that converge to form a V-shape groove adapted to receive a length of cable. The ridges of each groove are tilted relative to an axis perpendicular to the groove's longitudinal axis, such that the cable is progressively captured between the ridges of the opposing arrays as it settles into the crotch of the groove when moved in a first direction, and can be disengaged from the cleat by relaxing the axial force on the cable and moving it in the opposite direction. A linear actuator mechanism may be coupled to the sliding platform to move the platform with respect to the reaction frame.

Abstract: Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.

Abstract: Various forms of a cable fixation device, instrumentation, kit, and methods useful for repairing the skeletal system are introduced. The system utilizes a clamp housing fixing a butt end of a surgical cable therein. In an operative configuration the cable is looped around a damaged bone segment and reentered through a lock aperture in the clamp housing then through a collet and lock cap residing within the lock aperture. The cable loop and each aforementioned component comprise a central axis aligned within a single plane. A sliding interface situated between the lock cap and collet prevent twisting of the surgical cable. The locking mechanism is non-destructive to the cable despite repeated unlocking and relocking of the fixation device. The axis for tensioning of the cable is coincident with the locking axis. A counter torque instrument has a torsional input shaft generally perpendicular to the elongated axis of the instrument.

Abstract: A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place and maintain the tension previously achieved. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.

Abstract: A bone-tying cable tightening device is disclosed which makes itself unusable after having been used a predetermined number of times.

Abstract: A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place. The instrument preferably decreases the upward tension applied to the flexible sutures over the duration of the application of twisting. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.

Abstract: A method for spinal rod insertion includes providing a U-shaped hook tool comprising first and second legs, and inserting the first leg into a first location of a first vertebra and then pushing the hook tool along an arc-shaped path until the first leg exits through a second location of an adjacent second vertebra. Next, providing a spinal stabilization rod and a folded flexible wire comprising first and second open ends at the front end and a closed loop end. The closed loop end is attached to a first end of the spinal stabilization rod and the first and second open ends of the folded flexible wire are inserted into an open end of the second leg of the hook, and the folded flexible wire is threaded through the U-shaped hook and the first and second open ends of the flexible wire exit through an open end of the first leg.

Abstract: Instruments and techniques to pass a suture are presented. In one illustrative example, a suture passer includes a guide operable to guide the formation of a tunnel in a bone and guide passage of a suture through the tunnel so formed.

Abstract: The present disclosure generally provides systems and methods of anchoring surgical wires, catheters, leads, and other medical objects in an effective, efficient, and cost-sensitive manner. In one embodiment, the present disclosure could include a system to secure a medical object. The system could include a body having a first inner arm, a second inner arm, and a first outer arm. The first inner arm and the first outer arm could include a pronged structure. The system could also include a crossbar having a bore to receive a screw. The crossbar could be disposed between opposing surfaces of the first inner arm and the second inner arm and could be coupled to sliding grooves disposed along the opposing surfaces. When the screw is in an engaged position relative to the crossbar, the pronged structure could be configured to secure the medical object.

Abstract: A cannulated medical instrument handle apparatus comprises a handle housing component with a hollow handle insert channel and a tubular insert that fits within the handle insert channel. The airspace chamber created between the inner walls of said channel and the outer walls of said insert provides the handle with increased susceptibility to sterilization of the cannula lumen.

Abstract: A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place. The instrument preferably decreases the upward tension applied to the flexible sutures over the duration of the application of twisting. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.

Abstract: The present disclosure relates to a device for use during ligament reconstruction surgery. The device includes a handle and a shaft coupled to the handle, the handle including a first channel for housing of an insert, a second channel, a third channel for housing of the shaft, a first window, a second window, and a groove. A method for use during ligament reconstruction surgery is also disclosed.

Abstract: A facet fixation device formed from an anchor screw and a collet or facet screw that is secured to adjacent pedicles. The anchor screw having an aperture for receipt of a first end of guide wire or polyaxial based facet screw. The collet includes a unidirectional attachment mechanism wherein a wire can be drawn to a desired position to fix the distance between the anchor screw and the collet. Excess wire can then be removed.

Abstract: A guide apparatus having a body having a central axis defined therethrough and a first channel and a second channel formed therethrough, a handle coupled to the body, the handle having a locking mechanism configured to prevent movement of the body relative to the handle in a first direction along the central axis of the body, and an arm coupled to the handle, the arm configured to engage at least a portion of a bone.

Abstract: A driver for medical wires has a hollow drive shaft, rotatable about a rotation axis. The hollow drive shaft has a distal end and a proximal end. Furthermore, a plurality of clamping jaws penetrates under an angle into the hollow drive shaft close to its distal end. The clamping jaws are moved into or out of the hollow drive shaft by means of a jaw guide mounted slidable parallel to the rotation axis and movably connected to the clamping jaws. An actuator is provided to shift the jaw guide parallel to the rotation axis and therefore modify the penetration depth of the clamping jaws.

Abstract: An implant assembly includes a first implant member, a second implant member, and a contractible element that is connected between the first and second implant members. The first implant member is configured to be placed against a first bone portion, and the second implant member is configured to be placed against a second bone portion. The contractible element is fixed at a first end to one of the first and second implant members, and movable at a second end with respect to one of the first and second implant members so as to induce tension in the suture, thereby providing a compressive force against the first and second bone portions. The second end can then be fixed with respect to the first and second implant members. The contractible element can contract in length in response to bodily fluids, thereby ensuring adequate post-operative compression. An instrument is also disclosed that is configured to implant the first and second implant members adjacent the first and second bone portions, respectively.

Abstract: A surgical instrument for use in performing anterior cruciate ligament reconstructions includes an elongate body section having a handle portion for a user to grasp the instrument, and a head section having a curvilinear groove formed therein adapted for receiving and frictionally engaging a guide wire. The head section can include an end portion having a contour anatomically conforming to the femur. The instrument can direct a guide wire to an anatomic position on the femur.

Abstract: A system, devices and methods are provided for facilitating stabilization of periarticular fractures. The system includes a compression plate and one or more of a cerclage cable for encircling the bone and securing the compression plate to the bone, a crimp lug for securing the cable in tension relative to the bone and/or a plate, and a supplemental plate coupled to the compression plate and adapted to receive bicortical or unicortical bone screws to further secure the compression plate relative to the bone. In addition, the system includes a cable tensioner for temporarily retaining the cable in tension and then applying a tension to the cable until a desired compression is effected between a plate and bone and while a cable retaining structure is secured to the cable to retain the applied tension on the cable. Also provided is a jig for use with plates for minimally invasive fracture stabilization.

Abstract: Instruments and techniques to pass a suture are presented. In one illustrative example, a suture passer includes a drill guide and is able to form a tunnel in a bone and pass a suture through the tunnel so formed.

Abstract: An orthopedic tool having a one-way lock bearing and a one-way actuator bearing for tensioning surgical cables around a bone and a method for using the same.

Abstract: A method of using a tenolysis tool with a handle connected to at least two extension members which could be tines of a fork separated by a gap. Between the extension members and at least a portion of the handle may be a torque device selected from the group of a torque release and a torque indicator. By placing a tendon in the gap between the tines, the tool can be twisted so that the tendon is stretched under a torque.

Abstract: A device for treating bone fractures, comprises an actuating mechanism removably coupleable to a clamping mechanism including a clamp defining a cable receiving channel extending therethrough and a compression member coupled to the clamp for movement relative thereto, movement of the compression member relative to the clamp in a first direction moving the clamping mechanism into a clamping configuration in which at least a portion of the clamp is compressed into the channel to fix a cable received therein relative to the clamping mechanism. The actuating mechanism includes a first member and a second member removably engagable with a clamping mechanism so that, when engaged, relative movement between the first and second members causes relative movement between the clamp and the compression member to move the clamping member between the clamping configuration and a release configuration, the actuating mechanism further including a tensioning mechanism.

Abstract: A distance indicator for indicating the distance that a device has traveled includes an elongate housing with a guidewire connector configured for operative connection to a guidewire to hold the housing stationary with respect thereto. A plunger is operatively connected to the housing for longitudinal motion with respect to the housing. A first plunger end is configured to operatively contact the device. As the guidewire connector is holding the housing stationary with respect to the guidewire, the first plunger end is placed into operative contact with the device with the plunger and housing in a first relative plunger/housing position. The device moves longitudinally. The plunger moves into a second relative plunger/housing position assisted by the operative connection between the first plunger end and the device. The longitudinal difference between the first and second relative plunger/housing positions indicates a distance that the device has moved longitudinally with respect to the guidewire.

Abstract: A guide and method for cutting bones adjacent a joint at locations referenced to the joint anatomy is presented.

Abstract: A cable tensioning system includes a reaction frame which contains a sliding platform arranged to move linearly within the frame, and a clam-type cleat attached to the sliding platform. The cleat features one or more grooves, each of which comprises two arrays of opposing ridges that converge to form a V-shape groove adapted to receive a length of cable. The ridges of each groove are tilted relative to an axis perpendicular to the groove's longitudinal axis, such that the cable is progressively captured between the ridges of the opposing arrays as it settles into the crotch of the groove when moved in a first direction, and can be disengaged from the cleat by relaxing the axial force on the cable and moving it in the opposite direction. A linear actuator mechanism may be coupled to the sliding platform to move the platform with respect to the reaction frame.